Photography in Aesthetic Head and Neck Surgery

Chapter 9. Photography in Aesthetic Head and Neck Surgery

Kenneth B. Hughes, MD

All plastic surgeons must acquire the ability to record their results as accurately and precisely as possible. Photography becomes a unique ally in this pursuit, and it is incumbent upon plastic surgeons to develop a relatively sophisticated understanding of photography and its components. Unfortunately, much of the art of photography must be self-taught.

With this is mind, this chapter represents a compendium of insights from several dozen amateur and professional photographers to help elucidate fundamental concepts in photography. The chapter also explores issues in photography singular to plastic surgery and reviews the plastic surgery literature as it relates to photography.

THE DIGITAL REVOLUTION

The advent of digital photography has rendered conventional film all but obsolete, as digital images can be manipulated, archived, and reconstituted with software to create 3-dimensional images. Digital imaging and manipulation have revolutionized preoperative planning as well as patient counseling.

The advantages of digital photography are manifold and include no film or processing costs, no need for physical storage of slides or negatives, elimination of scanning of slides, immediate viewing of image, ability to erase images instantly and reuse space, digital compression, and transmission for purposes of consultation or discussion.

DIGITAL IMAGE CAPTURE

The development of the charge-coupled device (CCD) in 1969 created an image sensor tuned to the visible spectrum of light, which was able to convert captured light to electrical charge. An image is projected onto a capacitor array, causing each capacitor to store an electric charge proportional to light intensity at that location. Ultimately, these charges are converted to binary representation stored digitally. Most cameras are CCD or CMOS (complementary metal–oxide–semiconductor), both of which are composed of silicon doped with other elements that allow light sensitivity. Red, green, and blue filter strips are placed before the sensor to enable digitization of the color components.

In common parlance, the digital image is captured across an array of pixels. Thus, the number of pixels becomes a determinant of picture resolution. However, the number of megapixels is only one factor. Pixel size relative to overall size of imaging area on the sensor is also important, but difficult to determine. Thus, technical reviews and your own observations can prove more reliable.